Prevalence of children with blood pressure measurements exceeding adult cutoffs for optimal blood pressure in Germany

BACKGROUND: Despite a growing interest in the epidemiology of paediatric hypertension, data on how often blood pressure in children and adolescents already exceeds adult thresholds for optimal blood pressure are scarce. The aim of this study was to estimate the prevalence of higher-than-optimal and hypertensive blood pressure values according to adult cutoffs in an unselected representative sample of children and adolescents living in Germany. METHODS: Standardized oscillometric blood pressure measurements were performed in 14 730 children aged 3-17 years (7203 girls and 7527 boys) participating in a nationally representative examination survey of children and adolescents living in Germany (The German Health Interview and Examination Survey for Children and Adolescents, KiGGS, response rate 67%). The mean of two measurements was used for this analysis. RESULTS: The prevalences of higher-than-optimal blood pressure values by adult criteria (>or=120/80 mmHg) increased with age and was 52.2% in boys aged 14-17 years and 26.2% in girls aged 14-17 years (including 6.0% of boys and 1.4% of girls with hypertensive values >or=140/90 mmHg). More than half of these adolescents with nonoptimal blood pressure values had additional cardiovascular risk factors (overweight defined as body mass index >or=90th percentile for sex and age, dyslipidaemia defined as total cholesterol >5.0 mmol/l or high-density lipoprotein cholesterol less than 1.0 mmol/l or smoking). CONCLUSION: These results suggest the need for routine blood pressure measurements in children and adolescents as required by clinical guidelines, for more attention to coexisting other cardiovascular risk factors and for a sustained focus on healthy lifestyles that can be learned best at a young age.